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目的观察树突状细胞(dendritic cells,DC)和细胞因子诱导的杀伤细胞(cytokine-induced killer cells,CIK)联合白介素-2(interleukin-2,IL-2)治疗肾癌的疗效。方法回顾性分析2005年7月至2011年6月间60例肾癌术后患者,分离外周血单核细胞,体外诱导生成DC细胞;T淋巴细胞体外诱导生成CIK细胞。患者在切除原发病灶后,接受DC+CIK细胞免疫治疗,并给予IL-2静滴21 d。免疫学反应和临床疗效分别通过淋巴细胞亚群分析、影像学检查进行评估。结果治疗后患者外周血细胞毒T细胞、NK细胞、NKT细胞百分比较治疗前增高,差异有统计学意义。42例Ⅰ～Ⅲ期行根治性肾切除术患者,2例失访,1例复发,余未见复发、转移,随访时间7～67个月,中位随访时间16个月;18例Ⅳ期行姑息性肾切除患者中1例失访,随访的17例中1例CR,3例PR,8例SD,5例PD,随访时间6～66个月,中位随访时间15个月,无显著不良反应出现。结论 DC+CIK联合IL-2治疗能够增强肾癌术后患者的免疫功能,降低根治性切除术后肿瘤的复发率,并且对于转移性肾癌的治疗也显现一定的疗效,耐受性良好。
Objective To observe the effect of dendritic cells (DCs) and cytokine-induced killer cells (CIK) combined with interleukin-2 (IL-2) on renal cell carcinoma. Methods Sixty patients with renal cell carcinoma from July 2005 to June 2011 were retrospectively analyzed. Peripheral blood mononuclear cells (DCs) were isolated and induced to produce DC cells in vitro. T lymphocytes induced CIK cells in vitro. After excision of the primary lesion, the patients received immunotherapy with DC + CIK cells and were given IL-2 intravenously for 21 days. Immunological response and clinical efficacy were assessed by lymphocyte subsets, imaging studies. Results The percentages of cytotoxic T cells, NK cells and NKT cells in peripheral blood of patients after treatment were higher than those before treatment, the difference was statistically significant. Forty-two patients underwent radical nephrectomy in stage Ⅰ ~ Ⅲ, 2 cases were lost to follow-up, 1 case had recurrence, and no recurrence and metastasis were observed. The follow-up time ranged from 7 to 67 months with a median follow-up time of 16 months. Among the 17 patients who underwent palliative nephrectomy, 1 patient was lost to follow-up, 1 patient had CR, 3 patients had PR, 8 patients had SD and 5 patients had PD. The follow-up time ranged from 6 to 66 months. The median follow-up time was 15 months. Significant adverse reactions occurred. Conclusions DC + CIK combined with IL-2 can enhance the immune function of postoperative patients with renal cell carcinoma and reduce the recurrence rate of the tumors after radical resection. It also shows a certain curative effect and good tolerability for the treatment of metastatic renal cell carcinoma.